title: Emergence of ciprofloxacin-resistant coagulase-negative staphylococcal skin flora in immunocompromised patients receiving ciprofloxacin.
abstract: Seven septicemias in neutropenic leukemia patients (two with fatal outcome) caused by ciprofloxacin-resistant coagulase-negative staphylococci were diagnosed in the hematologic unit of Turku University Central Hospital in 1988 soon after the introduction of the drug. Coagulase-negative staphylococcal skin flora of 28 neutropenic patients receiving ciprofloxacin prophylaxis and therapy for gram-negative bacterial infections were compared with those of 31 untreated patients and 33 hospital personnel working in the same unit. In ciprofloxacin-treated patients the flora were almost completely ciprofloxacin-resistant, whereas in the control groups resistant flora were detected only occasionally. Similarities in the plasmid profile patterns were found in 91% of the ciprofloxacin-resistant coagulase-negative staphylococci, suggesting an epidemiologic relation between these strains. It seems evident that cross-infection is responsible for the spread of ciprofloxacin-resistant coagulase-negative staphylococci in these patients.
authors.affiliation: Department of Medicine, Turku University Central Hospital, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Kotilainen
authors.forename: J
authors.initials: J
authors.lastname: Nikoskelainen
authors.forename: P
authors.initials: P
authors.lastname: Huovinen
mesh_terms: D000368:Aged; D002939:Ciprofloxacin / Q000494:pharmacology*; D003030:Coagulase / Q000378:metabolism; D004352:Drug Resistance, Microbial / Q000235:genetics; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000276:immunology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000276:immunology; D009503:Neutropenia / Q000150:complications / Q000276:immunology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000276:immunology; D011815:R Factors; D018805:Sepsis / Q000188:drug therapy / Q000209:etiology*; D012867:Skin / Q000382:microbiology; D013210:Staphylococcus / Q000187:drug effects* / Q000235:genetics / Q000378:metabolism; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification
chemical_list: D003030:Coagulase; D002939:Ciprofloxacin